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Interesting article about exercise and enlarged hearts.


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  • Interesting article about exercise and enlarged hearts.

    I guess most in the HCM community already knew this, but it helps to have reinforcement and a study to back it up.


    Workouts sculpt heart as well as muscles

    Wed May 7, 2:24 PM ET

    Exercise can cause structural changes in the heart, and these changes vary depending on the type of training an athlete is engaged in, new research shows.

    In a study, researchers found that endurance athletes showed an increase in the size of both their left and right ventricles after 90 days of team training, while athletes who only did strength training had excessive growth in their left ventricles, but no change in their right ventricle size.

    And while the ability of the left ventricle to fully relax between beats, or diastolic function, was enhanced in the endurance athletes, it worsened in the strength trainers, Dr. Aaron L. Baggish of Massachusetts General Hospital in Boston and colleagues found.

    Small studies have found that the left ventricle, the heart's main pumping chamber, is larger in trained athletes, although there has been no research on how exercise affects the structure of the right ventricle. It is also unclear whether exercise itself changes the structure of the heart or whether individuals with unusually large left ventricles are more likely to become athletes.

    To investigate, Baggish and colleagues studied 40 endurance athletes and 24 strength athletes, examining their hearts with echocardiography before and after 90 days of team training. The endurance group included male and female long-distance rowers, while the strength group consisted of male football players.

    While left ventricle mass increased in both groups, the endurance athletes also showed better diastolic function in their left ventricle, and enlargement and more efficient contraction and relaxation in both of the lower chambers of the heart, or atria.

    But the strength-trained athletes actually had hypertrophy, or excessive growth, in the muscle of the left ventricle, and reduced diastolic function, but no other structural changes.

    The findings "strongly refute" the idea that people are able to become competitive athletes due to their heart structure, and instead demonstrate that it is athletic training itself that is largely responsible for "athlete's heart," the investigators write.

    The results could also point the way to making tailored recommendations for rehabilitation and recreational exercise for people with heart problems, they add.

    SOURCE: Journal of Applied Physiology, April 2008.
    Mitral valve repair and septal myomectomy May 1999 @ 36 yo. No ICD.

  • #2
    Re: Interesting article about exercise and enlarged hearts.

    Very interesting indeed. Reading stuff like this makes me wonder about my diagnosis. I clearly have a hypertrophied left ventricle with slight obstruction during exercise. Other than the hypertrophy I'm asymptomatic, have no family history of sudden death, and have been lifting weights off and on the majority of my life. Very interesting indeed.

    Anyone else have thoughts on my situation?


    • #3
      Re: Interesting article about exercise and enlarged hearts.

      All I can say is I met a women over this past weekend whose husband had been diagnosed with "hypertrophied heart", less then a year ago. He was not put on any medication , he was not told to stop jogging or lifting weights, she said he was relatively asymptomatic other then a few dizzy spells here and there and one syncope episode when he was much younger. He was VERY physically fit. I believe he was at 38 years of age,2 biological daughters, age 3 and 5 and one step daughter, age 11, married short of 7 years to his "soul " mate. He went out for a prayer walk just 5 levels below their home in San Diego, Ca. He died suddenly, this was last fall.

      She is DEVASTATED and continues to exhibit SHEAR SHOCK AND HORROR as she describes his life and death. I was so moved by her, for her, that she and her story of this sad , sad loss, will remain very sharp in my memory ..probably for always and I probably will relay it to many more for always.
      The ramifications of this loss will ripple out around her and her family for all time. I believe through her loss she will make an impact on many, many people and those of us impacted by meeting her will make an impact when we tell her story and so on and so on.....

      Hearing this womens painful story and watching and sharing .. makes all the losses here on the message board all the more real and dimensional.

      I am sharing this with you because there are similarities in your story . DO GET THE BEST HCM CARE AND OPINION...PLEASE.
      Dx @ 47 with HOCM & HF:11/00
      Guidant ICD:Mar.01, Recalled/replaced:6/05 w/ Medtronic device
      Lead failure,replaced 12/06.
      SF lead recall:07,extracted leads and new device 2012
      [email protected] Tufts, Boston:10/5/03; age 50. ( [email protected] 240 mmHg ++)
      Paroxysmal A-Fib: 06-07,2010 controlled w/sotalol dosing
      Genetic mutation 4/09, mother(d), brother, son, gene+
      Mother of 3, grandma of 3:Tim,27,Sarah,33w/6 y/o old Sophia, 5 y/o Jack, Laura 34, w/ 5 y/o old Benjamin


      • #4
        Re: Interesting article about exercise and enlarged hearts.

        Good advice Pam.

        Diagnosed in June 2007, Pacemaker Oct 2007, Myectomy in Feb 2009 at Cleveland Clinic, Two daughters, both checked with Ultrasounds in 2008, all OK so far. Two grandchildren both check with Ultrasounds and all is OK to date. OH YES....Harry, the Doggie, says Hi also. sigpic


        • #5
          Re: Interesting article about exercise and enlarged hearts.

          Trust me I'm being cautious. I have a child I need to worry about before my personal hobbies. I've accepted the fact I won't be able to lift weights just for the fact it seems to promote heart muscle growth, if nothing else. I'm on the meds I was prescribed and following their recommendations for exercise.

          I just can't help but wonder and investigate the possibilities. My lack of symptoms and lack of family history gives me some hope. I can't seem to even find a relative with an abnormal echo much less more serious symptoms. I do have a family history of high blood pressure, but all echos have come out normal.

          I did have a grandfather that died of aortic stenosis at an early age, but it wasn't at all sudden from what I'm told. He had rheumatic fever as a child which I'm told often leads to aortic stenosis. I had heard the condition and HCM can be difficult to differentiate, does anyone know much about the correlation?


          • #6
            Re: Interesting article about exercise and enlarged hearts.

            Aortic stenosis can be caused by rheumatic fever or just wear and tear on the aortic valve with aging that leads to restricted outflow. Since it is a restriction of the outflow tract it can show symptoms similar to obstructive HCM. Many patients at last weekend's HCMA meeting talked about years of mis-diagnosis by otherwise competent cardiologists. HCM is different than aortic stenosis. HCM is associated with a disarray of the muscle cells in the heart. This generally results in electrical conduction changes that show up on an ECG. It takes an experienced doctor (experienced in HCM) to interpret the echocardiogram of an enlarged heart from an HCM heart but it can be done, and the ECG should corroborate the finding. In other words, please see an HCM specialist at one the HCM Centers, where they have all the best echo and ECG technicians, to confirm your diagnosis.


            • #7
              Re: Interesting article about exercise and enlarged hearts.

              Thanks for the info Emily'sdad. I've been to a center already, and I'm following their treatement plan as well as restrictions. I'm just too stubborn to lay down easily. Gotta look for reasons to hope I can go back to doing some of the things I used to enjoy.


              • #8
                Re: Interesting article about exercise and enlarged hearts.


                This is Benjamin Lee. You sound very to me. I was diagnosed last year, just got back from a follow up visit. I had no change in the echo, or the MRI. I have active with sports (cross country, basketball, weight lifting) since late high school. Have not had any symptoms and I currently don't know of any family history. I currently don't have any arrythmia's. I am in the process of getting the reveal device put in to make sure I don't have any arrythmia's. Take care.


                • #9
                  Re: Interesting article about exercise and enlarged hearts.

                  Hey Ben,

                  Do you mean a holter monitor? I just did a 48hr monitor (had only done 24hrs before) and everything came back clear which is great. However, I also had a chat with my Doc and she was positive I had HCM and not any form of athlete's heart, for a couple reasons (localization at the septum and lack of increase in the whole heart size). She did however allow me to do some occasional resistance training which I'd previously been discouraged from, although she did say take it easy. So I'll only be doing a couple sets of push ups and sit ups a week.

                  On a side note, she didn't seem to think my Grandfather's case of aortic stenosis was at all related to my HCM. So at this point I can't find any family link, other than what seems to be chronic high blood pressure on one side of the family, but everyone else's echo comes back fine.

                  Is it possible the HCM genes are present but without some sort of agitation the growth does not occur?


                  • #10
                    Re: Interesting article about exercise and enlarged hearts.

                    It's probable that people can have the gene mutation that causes HCM yet not to express the disease. However, I don't think there are any environmental causes that would make a person develop HCM versus being a carrier. I think that about 95% or so of the cases of gene mutation results in expression of HCM sometime in life, although the actual disease may not manifest until you're well into adulthood, sometimes even in the 5th or 6th decade of life. It's so complicated and I don't think anyone knows why it happens this way sometimes. I'm sorry I don't have more of an explanation.

                    Husband has HCM.
                    3 kids - ages 23, 21, & 19. All presently clear of HCM.


                    • #11
                      Re: Interesting article about exercise and enlarged hearts.

                      Reenie's exactly right.

                      I have had one or more HCM genes my entire life, but no obstruction or other symptoms were ever noticed until I was 47. Other people go longer -- even their whole life -- without symptoms.

                      We don't have genes that "cause HCM" in any direct sense. We have genes that make our heart muscle use energy inefficiently. If you drive an underpowered car, you find yourself putting your foot to the floor even to go up mild hills. Our hearts do something analogous: to get enough force out of the energy they're able to use, the cardiac muscle cells hypertrophy.

                      One thing this means is that whether you get symptoms, when you get them, and how severe they are, all depend on many different things -- including the other genes you have that affect how your heart works, genes you have that affect demands on your heart, your environment, how demands are placed on your heart . . . the list is really long!

                      When I say "your environment" I don't necessarily mean anything like exposure to noxious chemicals. I mean the kind of life you live -- and have lived in the past. My body acts the way it does because of my genes, because of my mother's nutrition when she was pregnant with me, because of my entire history of diet, exercise, and many other factors -- and all the interactions between these things.

                      What all this means is that yes, it is possible for people to be "carriers" (they have the gene but no disease symptoms). And because the way the disease appears to us and our doctors varies so much, there are undoubtedly a fair number of people with HCM who aren't diagnosed as such.

                      I hope this helps.

                      Myectomy on Feb. 5, 2007.


                      • #12
                        Re: Interesting article about exercise and enlarged hearts.

                        In the past, I've researched to look for this or any stats on it, but haven't been able to find it; I'm just curious if you remember where you've heard or read about the "about 95%" vs. the other about 5%?

                        Originally posted by Reenie View Post
                        It's probable that people can have the gene mutation that causes HCM yet not to express the disease. However, I don't think there are any environmental causes that would make a person develop HCM versus being a carrier. I think that about 95% or so of the cases of gene mutation results in expression of HCM sometime in life,
                        Philippians 4:4-9; Wife, & 39 yo Mom to 9 year old son and 6 year old son/daughter twins; Diagnosed with HoCM 1999; Cleveland Clinic Myectomy and ICD, January 2006.


                        • #13
                          Re: Interesting article about exercise and enlarged hearts.

                          You know, I don't remember for sure, but I think it was in the first edition of the Hypetrophic Cardiomyopathy: For Patients, Their Families, and Interested Physicians book by Dr. Maron and Lisa. Below is a quote from page 5, in the section titled "What is the cause of HCM?", but it doesn't answer the 95/5 split.

                          Genetic "skipping" of a generation is rare but can appear to occur when an individual who is a gene carrier does not even have evidence of the disease on the echocardiogram. In such a circumstance, the mutant gene does not actually "skip" a generation - in reality, the HCM gene in that individual simply does not express itself fully, in such a way that we can see evidence of the disease with the echocardiogram (or electrocardiogram).

                          Husband has HCM.
                          3 kids - ages 23, 21, & 19. All presently clear of HCM.